A NEW APPLICATOR DESIGN FOR ENDOCAVITARY BRACHYTHERAPY OF CANCER IN THE NASOPHARYNX

Introduction: In attempting to improve local tumor control by higher d oses of radiation, there has been a resurgence of interest in the impl ementation of brachytherapy in the management of primary and recurrent cancers of the nasopharynx. Brachytherapy with its steep dose fall-of f is of particular interest because of the proximity of critical dose limiting structures. Recent developments in brachytherapy, such as the introduction of pulsed-dose-rate and high-dose-rate computerized afte rloaders, have encouraged further evolution of brachytherapy technique s. Materials and methods: We have designed an inexpensive, re-usable a nd flexible silicone applicator, tailored to the shape of the soft tis sues of the nasopharynx, which can be used with either low-dose-rate b rachytherapy or high (pulsed)-dose-rate remote controlled afterloaders . Results and conclusions: This Rotterdam nasopharynx applicator prove d to be easy to introduce, patient friendly and can remain in situ for the duration of the treatment (2-6 days). The design, technique of ap plication and the first consecutive 5 years of clinical experience in using this applicator are presented. (C) 1997 Elsevier Science Ireland Ltd.